Which of the following is NOT a top NSAID with the highest cox1:cox2 ratio?

The question asks for the option that is not considered a top nonsteroidal anti-inflammatory drug (NSAID) with a high COX-1 to COX-2 ratio. The COX-1 enzyme is primarily associated with the production of protective gastric mucosa and platelet aggregation, whereas COX-2 is more involved in the inflammatory response.

Aspirin is well-known for its ability to inhibit COX-1 significantly, which is why it is used for its anti-platelet effects. While it does inhibit COX-2, it does so to a lesser extent compared to its inhibition of COX-1. This characteristic exemplifies why aspirin is considered to have a high COX-1 to COX-2 ratio, making it a prime example of an NSAID that acts more on COX-1.

In contrast, other options such as Ketoprofen, Fenoprofen, and Tolmetin do not exhibit a high COX-1 preference in the same manner. These NSAIDs have more balanced or even greater COX-2 inhibitory effects, making them less representative of that high COX-1 to COX-2 ratio. Therefore, selecting aspirin as the answer accurately identifies it as a top